McKenzie Kate Waldrep, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1638 Owen Dr
Fayetteville, NC 28304-3424

Phone

(910) 615-3500

NPI assigned

May 5, 2025

Last updated

May 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• McKenzie Kate Allen Former name

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1336938489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 DUNDEE CT",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309072558",
            "telephone_number": "706-834-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDREP",
        "first_name": "MCKENZIE",
        "middle_name": "KATE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCKENZIE",
            "last_name": "ALLEN",
            "middle_name": "KATE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wal-Mart Stores East LP (Walmart Pharmacy 10-6879)
• Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
• Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
• Wal-Mart Stores, Inc. (Vision Center 30-3595)
• Gabrielle Walatee
• Cornelia C Waldrum, PT
• Carrie Waleisky
• Sophia Walfall
• Jason Walgos, DNP
• Walgreen Co (Walgreens #19644)

• Student in an Organized Health Care Education/Training Program in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Student in an Organized Health Care Education/Training Program in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.